Eating Disorders in Midlife: Breaking the Cycle of Body Image Struggles

In her book Pursuing Perfection, eating disorder expert Margo Maine writes:

“Clearly, the passage of time isn’t helping aging women feel more at peace with their bodies, or making things better for younger women following them into adulthood. The legacy of body image and weight obsession is passed down from one generation to the next, reinforced for women of all ages by the body myths of our youth- and appearance-oriented culture.”

This highlights a painful reality: adult women are at risk for eating disorders. But because we live in a culture that not only tolerates but celebrates disordered behaviors, they often go unrecognized.

Patterns of overexercise, rigid control of food intake (for themselves or their families), and constant rumination about body and appearance are normalized. The pain that results is invalidated. And because those suffering are adult women who no longer fit the stereotype of “who gets an eating disorder,” they often suffer alone and for a long time.

Why Eating Disorders in Midlife Go Unrecognized

We recognize that teenagers may be vulnerable to eating disorders because of factors like body changes, hormonal fluctuations, identity development, shifting roles, and cultural pressures. But these same factors—body changes, hormonal shifts, evolving identity, increasing responsibilities, and societal expectations…hey, perimenopause!—also affect adult women, particularly those in midlife. And yet, their struggles are often overlooked.

The Normalization of Disordered Behaviors

Behaviors that would raise red flags in teenagers—like chronic dieting, over-exercising, or body dissatisfaction—are often ignored or even praised in adult women. This can leave them suffering in silence, believing they must simply “try harder” instead of recognizing a need for support.

Common signs of disordered eating in adulthood:

• Chronic dieting and food restriction
• Obsession with “clean eating”
• Excessive exercise with guilt over rest days
• Negative self-talk about body image
• Anxiety or stress around meals

Risk Factors for Eating Disorders in Midlife

Both teens and adult women experience similar risk factors:

• Body changes
• Hormonal fluctuations
• Identity shifts
• Changing roles and responsibilities
• Cultural pressures and messaging

What the Research Says

American Women Over 50 (Gagne et al., 2012):

• 60% reported weight and shape concerns negatively affected their lives.
• 79% said weight and shape impacted their self-image.
• 41% weighed themselves daily.
• 36% spent at least half of the last five years dieting.
• 8% reported purging behaviors.
• Over 13% had current eating disorder symptoms.

American Women Aged 25-47 (Reba-Harrelson et al., 2009):

• 67% (excluding those with diagnosed EDs) were actively trying to lose weight.
• 39% said body/eating concerns interfered with happiness.
• 37% regularly skipped meals.
• 26% cut out entire food groups.
• 16% followed very low-calorie diets.
• 13% smoked to control weight.
• 75% reported symptoms consistent with eating disorders.

Shifting the Narrative: A New Vision for Women’s Bodies

Of course, it is important that we call out diet culture and its harmful cultural messages about bodies. But it’s also critical to offer an alternative—the possibility that adult women might experience respect, gratitude, and trust in their bodies rather than a constant struggle against them.

Imagine a world where:

• Women’s bodies are valued for their resilience, not their size.
• Food is a source of nourishment and joy, not guilt.
• Movement is about enjoyment, not punishment.
• Women feel confident and free in their bodies, rather than constrained by external expectations.

This shift challenges the harmful narratives women have inherited and offers hope for healing.

Supporting Healing Without Reinforcing Disordered Behaviors

Adult women are at risk for eating disorders, and we can support them in healing without reinforcing harmful behaviors.

A midlife experience that is anything less than confident, joyful, and spacious deserves to be taken seriously and met with care and support. If you or someone you love is struggling with disordered eating or body image distress, know that healing is possible at any age. Seeking support from a therapist specializing in eating disorders can be a powerful first step. (Oh, hi! 👋 That’s me!)

Breaking free from diet culture and embracing body trust is a courageous act—one that can lead to true freedom and self-compassion. You are worthy of that journey. 💛

Further Reading & Resources:

• Pursuing Perfection by Margo Maine
• Midlife Eating Disorders by Cynthia Bulik
• The Emotional Eating, Binge Eating, Chronic Dieting and Body Image Workbook by Christy Harrison, Amy Pershing, and Judith Matz

If this resonates with you, let’s continue the conversation. Get in touch or share this with someone who needs to hear it today.